Carlo Bellieni

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Carlo V. Bellieni (Siena, Italy, born 1962) is an Italian neonatologist and a bioethicist. [1] He served as Secretary of the Bioethics Committee of the Italian Pediatrics Society. [2] He is a member of the ethical board of the Siena Biotech research facility and the Ethical Board of the Siena University Hospital where he directs the neonatal intensive therapy unit. [3] [4] He follows the empirical approach in bioethics, which emphasizes realism, reason, and empathy. Bellieni authored numerous clinical research papers in international scientific journals, [5] [6] and several books on neonatal pain and bioethics.

Contents

Studies on infant pain

Bellieni created and developed a new method of nonpharmacological analgesia called "sensorial saturation", [7] based on the simultaneous administration of gentle stimuli (touch, taste and voice) to the baby during a painful procedure. This method is reported among the most effective for pain in babies. Bellieni also performed studies on babies' crying and developing a pain scale based on acoustical analysis of crying. [8]

Bellieni performed several analyses on babies' crying and showed that it is not useful to detect the cause that provoked it; nonetheless, it contain a sort of protolanguage, namely the patterns of crying change dramatically when it exceeds a certain pain threshold. [9]

Studies on crying and weeping

Bellieni analysed weeping behavior and concluded that most animals can cry, but only humans have psychoemotional tears, also known as weeping. Weeping induces empathy perhaps with the mediation of the mirror neurons network and influences mood through hormone release elicited by tears’ massage effect on cheeks or through relief from sobbing rhythm. [10]

Laughter

Laughter is a form of alarm siren that informs bystanders a worrying event is over. [11] According to Bellieni's studies, the characteristic worrying event is finding a "stiff" behavior within a "fluid" one: this contrast frightens us, and finding it resolved is a sudden joy that can be communicated to others. Laughter is rhythmic because it should have features of a real alarm siren to share this ceased alarm. [12]

Related Research Articles

<span class="mw-page-title-main">Laughter</span> Expression of amusement

Laughter is a pleasant physical reaction and emotion consisting usually of rhythmical, often audible contractions of the diaphragm and other parts of the respiratory system. It is a response to certain external or internal stimuli. Laughter can rise from such activities as being tickled, or from humorous stories, imagery, videos or thoughts. Most commonly, it is considered an auditory expression of a number of positive emotional states, such as joy, mirth, happiness or relief. On some occasions, however, it may be caused by contrary emotional states such as embarrassment, surprise, or confusion such as nervous laughter or courtesy laugh. Age, gender, education, language and culture are all indicators as to whether a person will experience laughter in a given situation. Other than humans, some other species of primate show laughter-like vocalizations in response to physical contact such as wrestling, play chasing or tickling.

Utilitarian bioethics refers to the branch of bioethics that incorporates principles of utilitarianism to directing practices and resources where they will have the most usefulness and highest likelihood to produce happiness, in regards to medicine, health, and medical or biological research.

<span class="mw-page-title-main">Shaken baby syndrome</span> Medical condition

Shaken baby syndrome (SBS), also known as abusive head trauma (AHT), is a medical condition in children younger than five years old, generally caused by blunt trauma, vigorous shaking, or a combination of both. SBS is the leading cause of fatal head injuries in children under two, with a risk of death of about 25%. The most common symptoms include retinal bleeds, multiple fractures of the long bones, and subdural hematomas.

<span class="mw-page-title-main">Apgar score</span> Scale for newborn viability

The Apgar score is a quick way for health professionals to evaluate the health of all newborns at 1 and 5 minutes after birth and in response to resuscitation. It was originally developed in 1952 by an anesthesiologist at Columbia University, Virginia Apgar, to address the need for a standardized way to evaluate infants shortly after birth.

Retinopathy of prematurity (ROP), also called retrolental fibroplasia (RLF) and Terry syndrome, is a disease of the eye affecting prematurely born babies generally having received neonatal intensive care, in which oxygen therapy is used because of the premature development of their lungs. It is thought to be caused by disorganized growth of retinal blood vessels and may result in scarring and retinal detachment. ROP can be mild and may resolve spontaneously, but it may lead to blindness in serious cases. Thus, all preterm babies are at risk for ROP, and very low birth-weight is an additional risk factor. Both oxygen toxicity and relative hypoxia can contribute to the development of ROP.

<span class="mw-page-title-main">Blue baby syndrome</span> Two situations that lead to cyanosis in infants

Blue baby syndrome can refer to conditions that cause cyanosis, or blueness of the skin, in babies as a result of low oxygen levels in the blood. This term has traditionally been applied to cyanosis as a result of:.

  1. Cyanotic heart disease, which is a category of congenital heart defect that results in low levels of oxygen in the blood. This can be caused by either reduced blood flow to the lungs or mixing of oxygenated and deoxygenated blood.
  2. Methemoglobinemia, which is a disease defined by high levels of methemoglobin in the blood. Increased levels of methemoglobin prevent oxygen from being released into the tissues and result in hypoxemia.
<span class="mw-page-title-main">Pulse oximetry</span> Measurement of blood oxygen saturation

Pulse oximetry is a noninvasive method for monitoring blood oxygen saturation. Peripheral oxygen saturation (SpO2) readings are typically within 2% accuracy of the more accurate reading of arterial oxygen saturation (SaO2) from arterial blood gas analysis.

<span class="mw-page-title-main">Kangaroo care</span> Technique of newborn care

Kangaroo mother care (KMC), which involves skin-to-skin contact (SSC), is an intervention to care for premature or low birth weight (LBW) infants. The technique and intervention is the recommended evidence-based care for LBW infants by the World Health Organization (WHO) since 2003.

<span class="mw-page-title-main">Baby colic</span> Medical condition

Baby colic, also known as infantile colic, is defined as episodes of crying for more than three hours a day, for more than three days a week, for three weeks in an otherwise healthy child. Often crying occurs in the evening. It typically does not result in long-term problems. The crying can result in frustration of the parents, depression following delivery, excess visits to the doctor, and child abuse.

<span class="mw-page-title-main">Neonatal intensive care unit</span> Intensive care unit specializing in the care of ill or premature newborn infants

A neonatal intensive care unit (NICU), also known as an intensive care nursery (ICN), is an intensive care unit (ICU) specializing in the care of ill or premature newborn infants. The NICU is divided into several areas, including a critical care area for babies who require close monitoring and intervention, an intermediate care area for infants who are stable but still require specialized care, and a step down unit where babies who are ready to leave the hospital can receive additional care before being discharged.

<span class="mw-page-title-main">Pediatric nursing</span> Nursing involving children

Pediatric nursing is part of the nursing profession, specifically revolving around the care of neonates and children up to adolescence. The word, pediatrics, comes from the Greek words 'paedia' (child) and 'iatrike' (physician). 'Paediatrics' is the British/Australian spelling, while 'pediatrics' is the American spelling.

<span class="mw-page-title-main">Neonatal jaundice</span> Medical condition

Neonatal jaundice is a yellowish discoloration of the white part of the eyes and skin in a newborn baby due to high bilirubin levels. Other symptoms may include excess sleepiness or poor feeding. Complications may include seizures, cerebral palsy, or kernicterus.

Prenatal perception is the study of the extent of somatosensory and other types of perception during pregnancy. In practical terms, this means the study of fetuses; none of the accepted indicators of perception are present in embryos. Studies in the field inform the abortion debate, along with certain related pieces of legislation in countries affected by that debate. As of 2022, there is no scientific consensus on whether a fetus can feel pain.

<span class="mw-page-title-main">Newborn transport</span> Movement of infants for medical purposes

Newborn transport is used to move premature and other sick infants from one hospital to another, such as a medical facility that has a neonatal intensive care unit and other services. Neonatal transport services such as NETS use mobile intensive care incubators fitted with mechanical ventilators, infusion pumps and physiological monitors capable of being used in a mobile environment. These transport systems seek to emulate the environment of a neonatal intensive care and permit uninterrupted care to occur in a referring hospital and then during the journey by road or air ambulance. Power and medical gas supplies are carried within the system as well as making use of external supplies; as available. Infant transport systems commonly weigh over 100 kg and present a challenge to vehicle operators in terms of weight, manual handling, crashworthiness and power consumption.

<span class="mw-page-title-main">Neonatal nursing</span>

Neonatal nursing is a sub-specialty of nursing care for newborn infants up to 28 days after birth. The term neonatal comes from neo, "new", and natal, "pertaining to birth or origin". Neonatal nursing requires a high degree of skill, dedication and emotional strength as they care for newborn infants with a range of problems. These problems vary between prematurity, birth defects, infection, cardiac malformations and surgical issues. Neonatal nurses are a vital part of the neonatal care team and are required to know basic newborn resuscitation, be able to control the newborn's temperature and know how to initiate cardiopulmonary and pulse oximetry monitoring. Most neonatal nurses care for infants from the time of birth until they are discharged from the hospital.

An asynclitic birth or asynclitism are terms used in obstetrics to refer to childbirth in which there is malposition of the head of the fetus in the uterus, relative to the birth canal. Asynclitic presentation is different from a shoulder presentation, in which the shoulder is presenting first. Many babies enter the pelvis in an asynclitic presentation, and most asynclitism corrects spontaneously as part of the normal birthing process.

<span class="mw-page-title-main">Crying</span> Shedding tears due to emotion or pain

Crying is the dropping of tears in response to an emotional state or pain. Emotions that can lead to crying include sadness, anger, excitement, and even happiness. The act of crying has been defined as "a complex secretomotor phenomenon characterized by the shedding of tears from the lacrimal apparatus, without any irritation of the ocular structures", instead, giving a relief which protects from conjunctivitis. A related medical term is lacrimation, which also refers to non-emotional shedding of tears. Various forms of crying are known as sobbing, weeping, wailing, whimpering, bawling, and blubbering.

Child euthanasia is a form of euthanasia that is applied to children who are gravely ill or have significant birth defects. In 2005, the Netherlands became the first country since the end of Nazi Germany to decriminalize euthanasia for infants with hopeless prognosis and intractable pain. Nine years later, Belgium amended its 2002 Euthanasia Act to extend the rights of euthanasia to minors. Like euthanasia, there is world-wide public controversy and ethical debate over the moral, philosophical and religious issues of child euthanasia.

Pain in babies, and whether babies feel pain, has been a large subject of debate within the medical profession for centuries. Prior to the late nineteenth century it was generally considered that babies hurt more easily than adults. It was only in the last quarter of the 20th century that scientific techniques finally established babies definitely do experience pain – probably more than adults – and developed reliable means of assessing and of treating it. As recently as 1999, it was widely believed by medical professionals that babies could not feel pain until they were a year old, but today it is believed newborns and likely even fetuses beyond a certain age can experience pain.

Neonatal withdrawal or neonatal abstinence syndrome (NAS) or neonatal opioid withdrawal syndrome (NOWS) is a withdrawal syndrome of infants, caused by the cessation of the administration of licit or illicit drugs. Tolerance, dependence, and withdrawal may occur as a result of repeated administration of drugs or even after short-term high-dose use—for example, during mechanical ventilation in intensive care units. There are two types of NAS: prenatal and postnatal. Prenatal NAS is caused by discontinuation of drugs taken by the pregnant mother, while postnatal NAS is caused by discontinuation of drugs directly to the infant.

References

  1. Alfano, Sean (16 August 2006). "TV Can Reduce Stress For Kids". CBS.
  2. "LIBRI: MEDICO CATTOLICO SCOPRE UN DOTTOR HOUSE BUONO /ANSA". Regione Toscana. 2 April 2009. Archived from the original on 7 September 2012.
  3. Colina, Jesus (26 May 2010). "Vatican Considering Ethics of "Synthetic Life"". Catholic.net.
  4. Sanderson, Katharine (2008). "Incubators seen to change babies' heartbeats". Nature. doi: 10.1038/news.2008.790 .
  5. "Worry over incubator 'emissions'". BBC News. 4 May 2008.
  6. "TV 'can numb pain for children'". BBC News. 17 August 2006.
  7. Bellieni CV, Buonocore G, Nenci A, Franci N, Cordelli DM, Bagnoli F (2001). "Sensorial saturation: an effective analgesic tool for heel-prick in preterm infants: a prospective randomized trial". Biology of the Neonate. 80 (1): 15–8. doi:10.1159/000047113. PMID   11474143. S2CID   40344983.
  8. Bellieni CV, et al. (2005). "Development and validation of the ABC pain scale for healthy full-term babies". Acta Paediatr. 94 (10): 1432–6. doi:10.1111/j.1651-2227.2005.tb01816.x. PMID   16299876. S2CID   23057839.
  9. Bellieni CV, et al. (2005). "Cry features reflect pain intensity in term newborns: an alarm threshold". Pediatric Research. 55 (1): 142–6. doi: 10.1203/01.PDR.0000099793.99608.CB . PMID   14605260.
  10. Bellieni, C. V. (1 December 2017). "Meaning and importance of weeping". New Ideas in Psychology. 47: 72–76. doi:10.1016/j.newideapsych.2017.06.003.
  11. Bellieni, Carlo V. (1 January 2023). "Laughter: A signal of ceased alarm toward a perceived incongruity between life and stiffness". New Ideas in Psychology. 68: 100977. doi:10.1016/j.newideapsych.2022.100977. S2CID   251826870.
  12. "Why do we laugh? New study considers possible evolutionary reasons behind this very human behaviour".